National Honor Society Application Form

BRANDYWINE HIGH SCHOOL

Keith Rolph, Principal Martin Regan, Assistant Principal Marqueia Davis, Assistant Principal

NATIONAL HONOR SOCIETY

Linda Dillon, Advisor

Erika Brown, Advisor

National Honor Society ApplicationChecklist

Personal data page

Two teacher recommendation forms – complete the top portions only anddeliver to your recommending teacher.

Signature page

Leadership personal statement

Resume

Community service form

School Activity form

Guidance Counselor recommendation form—complete the top portion only and deliver to your counselor.

Applications must be received by Friday, November 3, 2017

Deliver to Mrs. Steffin, Administrative Assistant in Counseling

BRANDYWINE HIGH SCHOOL

Keith Rolph, Principal Martin Regan, Assistant Principal Marqueia Davis, Assistant Principal

NATIONAL HONOR SOCIETY

Linda Dillon, AdvisorErika Brown, Advisor

The Minimum # of points needed for NHS selection is 8

Scholarship / Leadership / Service / Character
GPA / PTS / STANDARD / PTS /

HOURS

/ PTS / POINTS
Teacher & Counselor Rating
95+
90-94
85-89 / =
=
= / 3
2
1 / Exceeds
Meets
Below
Leadership is based on essay and Student Activities form. / =
=
= / 3
2
1 / *101+
76-100
51-75
1-50 / =
=
=
= / 4
3
2
1 / Outstanding & Excellent 4
Good & Above Average 3
Average 2
Below Average 1
Sub-Total / = / Sub-Total / = / Sub-Total / = / Sub-Total =
A “Grade Point Average” (GPA) is the cumulative average reflected on the student’s transcript at the end of the first marking period. / ESSAY STANDARD
EXCEEDS: Essay is well organized; demonstrates style and clarity. Provides thorough explanation of leadership activity. Uses precise language consistently appropriate to the purpose in a style that engages the reader.
MEETS: Essay shows relevant and sufficient examples of student leadership. Uses language appropriate to the purpose. Demonstrates a command of standard English conventions with occasional minor errors.
BELOW: Essay does not relate to the question and contains no example of leadership in action. Uses basic language with some improper usage of words and phrases. Grammar/Spelling errors detracts from the essay.
______
ACTIVITIES STANDARD
EXCEEDS: Student participates in 3 or more activities. At least 2 activities are for a year or more.
MEETS: Student participates in 2 activities. At least 1activity is for a year or more.
BELOW: Student participates in 1 or less activity and/or activity participation is for one semester. / A student must perform unpaid volunteer service to a non-profit organization in thelocal community.
Bonus point awarded to a student with documented community service exceeding 101 hours. / A student must demonstrate high standards of character.
The NHS Faculty Council considers subject area teacher input, Dean updates, and other relevant data / materials when evaluating character.

BRANDYWINE High School

National Honor Society Application

Personal Data

Name:______

LastFirst Middle

Address:______

Number and Street

______

City and StateZip Code

Home Telephone: ______Your Cell: ______

E-mail:______

General Directions: Use the checklist to be sure all parts of the application are included. Follow the specific directions on each page. Application pages may be completed online and then printed. Handwritten applications will not be accepted.

Incomplete applications will not be reviewed.

Return your completed application toMrs. Steffin in the counseling office.

Deadline: Friday, November 3, 2017

Teacher Recommendations: In the spaces below, name the two teachers you will ask to recommend you. Complete the table. A recommendationmust be given to a teacher whose class you have taken or are currently taking. You cannot use a coach, activity sponsor, counselor or non-teaching staff person.

Teacher / Course / Semester /Year

Questions: If you have questions or need help completing the application, you may contact one of the following advisors:

Linda Dillon Room 121

Erika Brown

BRANDYWINE High School

National Honor Society Application

Signature Page

To be completed by the applicant:

I understand that completing and submitting this application does not guarantee selection to the National Honor Society. I attest that the information presented here is complete and accurate. If selected, I agree to abide by the standards and guidelines of the chapter and to fulfill all of my membership obligations to the best of my ability.

Name:______

(Printed)

Signature:______

(Date)

To be completed by the parent or guardian of the applicant:

I have reviewed the application and give permission for my child to apply to the Brandywine High School chapter of the National Honor Society.

Name:______

(Printed)

Signature:______

(Date)

Daytime Telephone:______E-mail:______

Brandywine High School

National Honor Society Application

Leadership Personal Statement

Directions: Please answer the following question.

Follow this page with a resume that includes your name, work history and extracurricular activities.

How do you see yourself as a leader? Describe an activity or experience in which your participation made a difference. How did your leadership skills influence the outcome? Give examples.

(Maximum of 250 words)

Student Name: ______

BrandywineHigh School

National Honor Society Application

Community Service Form

Directions: Complete this page for your one or two most meaningfulunpaidcommunity service experiences. These should be events OUTSIDE of Brandywine High School activities.

Ask each sponsor to describe your service, confirm your length of service, comment and sign a letter on the letterhead stationery of the organization. Include the letter(s) with your application.

Student Name: ______

Organization:______

Address: ______

______

Telephone: ______E-mail:______

Dates of Service: ______Total Hours of Service: ______

Sponsor Name: ______

Sponsor Title: ______Sponsor E-mail:______

______

Organization:______

Address: ______

______

Telephone: ______E-mail:______

Dates of Service: ______Total Hours of Service: ______

Sponsor Name: ______

Sponsor Title: ______Sponsor E-mail:______

BrandywineHigh School

National Honor Society Application

School Activity Form

(Considered under the Leadership rubric)

Directions: List all activities in which you have participated during high school. Include clubs, teams, musical groups, etc. Please include any major accomplishments for an activity (ex. Captain, director, etc.). Also note the name of the faculty coordinator you work with in this activity.

ACTIVITY / YEAR
(9th, 10th, 11th) / Accomplishment / Faculty Coordinator

Student Name: ______

Brandywine High School

National Honor Society Application

Teacher Recommendation Form

Applicant: Complete the top portion only.

Student Name: ______

Teacher Name: ______

This student is seeking to become a member of the National Honor Society. The Faculty Council would like your input to help make its decision.

What course did you teach this student and when? ______

Check the appropriate box that best describes the character of the student.

Attribute / Truly Outstanding (top 2-3%) / Excellent
(Top 10%, but not top 2-3%) / Good / Average / Below Average / No Basis for Judgment
Responsibility
Maturity and self-discipline
Self-confidence
Sense of humor
Concern for others
Integrity
Reaction to setbacks
Compliance with school regulations
Cooperation with others

Recommendation:_____recommend without reservation

_____recommend with reservation(Please comment).

_____do not recommend(Please comment).

Comments:______

Signature ______

Printed Name ______Date ______

DO NOT RETURN TO THE APPLICANT.

Please sign and return to Mrs. Steffin in the counseling office by Friday, November 3, 2017

Thank you.

Brandywine High School

National Honor Society Application

Teacher Recommendation Form

Applicant: Complete the top portion only.

Student Name: ______

Teacher Name: ______

This student is seeking to become a member of the National Honor Society. The Faculty Council would like your input to help make its decision.

What course did you teach this student and when? ______

Check the appropriate box that best describes the character of the student.

Recommendation:_____recommend without reservation

_____recommend with reservation(Please comment).

_____do not recommend(Please comment).

Comments:______

Signature ______

Printed Name ______Date ______

DO NOT RETURN TO THE APPLICANT.

Please sign and return to Mrs. Steffin in the counseling office by Friday, November 3, 2017

Thank you.

Brandywine High School

National Honor Society Application

Assistant Principal and/or Dean’s Office

Applicant: Complete the top portion only.

Student Name: ______Official Class: ______

To the Dean’s Office: This student is seeking to become a member of the National Honor Society. The Faculty Council would like your input to help make its decision.

Name of Dean completing form: ______

Please verify if the student has a Dean’s record:

______No, Student does not have a discipline record.

______Yes, Student has a Dean’s office record. PLEASE COMPLETE SECTION BELOW.

_____Student was suspended. Please list dates and infraction:

Incident 1: ______

Incident 2: ______

Incident 3: ______

Recommendation:_____recommend without reservation

_____recommend with reservation(Please comment).

_____do not recommend(Please comment).

Comments:______

Signature ______

Printed Name ______Date ______

DO NOT RETURN TO THE APPLICANT.

Please sign and return to Mrs. Steffin in the counseling office by Friday, November 3, 2017

Thank you.

Brandywine High School

National Honor Society Application

Counselor Recommendation Form

Applicant: Complete the top portion only.

Student Name: ______

Counselor Name: ______

This student is seeking to become a member of the National Honor Society. The Faculty Council would like your input to help make its decision.

Check the appropriate box that best describes the character of the student.

Recommendation:_____recommend without reservation

_____recommend with reservation(Please comment).

_____do not recommend(Please comment).

Comments:______

Signature ______

Printed Name ______Date ______

DO NOT RETURN TO THE APPLICANT.

Please sign and return to Mrs. Steffin by Friday, November 3, 2017

Thank you.

Brandywine High School

National Honor Society Application

OPTIONAL-----NHS Officer Application

Applicant: If you are interested in being interviewed for an Officer Position of NHS, please review the roles of each position and complete the application as directed.

National Honor Society is a student run organization that requires time and dedication from its members but especially from its Officers.

Co-Leaders’ Roles and Expectations:

-Organize and run meetings

-Lead the planning of fundraisers and share important information with NHS members

-Work with the staff advisors in planning meetings and activities

-Schedule and attend weekly meetings with other officers

-Assist in contacting organizations that we would like to support

Treasurer Roles and Expectations:

-Manage finances

-Publicize to the school and community about activities NHS is organizing to increase participation in fundraising activities

-Assist in finding fundraisers that will help raise money for different organizations

Secretary Roles and Expectations:

-Take notes at meetings

-Maintain accurate attendance logs for meetings and events

-Maintain contacts for all NHS members (cell phone numbers and email addresses)

-Help organize tasks

-Make agendas for meetings

Applicant: Complete the following essay in a typed format that you should attach to your application. Your essay answer must include your name and the title “REQUEST TO BE CONSIDERED FOR NHS OFFICER POSITION”. You should also list the position(s) that you want to interview for.

ESSAY: Why do you think you would make a strong officer for NHS? Your essay should include how you manage your academics and extra-curricular activities and how the demands of NHS would fit into your senior year of high school.

Your essay should also include what characteristics or experience you have that fit the officer role you are applying for.

Student Name: ______

Brandywine High School

National Honor Society Application

OPT OUT FORM

To be completed by the applicant:

I do not wish to be a member of the National Honor Society

Name: ______

(Printed)

Signature: ______

(Date)

To be completed by the parent or guardian of the applicant:

I understand that my child does not wish to be a member of the National Honor Society.

Name: ______

(Printed)

Signature: ______

(Date)